Patient guide

What to bring

• MRI, CT and X-ray images with their reports, even old ones
• Any nerve and muscle test reports
• Details of earlier surgery and injections: when, how much they helped and for how long
• A list of all your medicines, especially blood thinners and painkillers
• Your insurance booklet, if it is accepted

Think about these questions before you come

• When did the pain start? Did something particular happen?
• Exactly where is it, and where does it travel?
• What makes it better or worse?
• What is it like at night?
• Do you also have numbness, tingling or weakness?
• What can you no longer do?

What happens at the visit?

The doctor listens to you, examines your movement, muscle strength, reflexes and sensation, and reads your scans alongside all this. Wear comfortable clothes that let the painful area be seen. It helps if someone can come with you.

Always tell us before the day if you

• Take a blood thinner, such as warfarin, clopidogrel or rivaroxaban
• Are or might be pregnant
• Are allergic to iodine, contrast dye, local anaesthetic or any medicine
• Have diabetes
• Have a fever or an infection
• Have heart failure

Do not stop a blood thinner yourself. Whether to stop or continue it is decided by your doctor with the doctor who prescribed it. The treatment centre gives clear instructions for your type of injection.

On the day

• Bring someone with you. Do not drive yourself.
• Carry on with your other regular medicines as instructed.
• If you are having sedation, follow the centre’s fasting instructions. People with diabetes should ask about their diabetes medicine.
• Wear comfortable clothes.
• If you have a fever or a bad cold, call before you come.

That day

• Your leg may feel numb or weak for two or three hours. Get up carefully and with help.
• Take it easy for the rest of the day. The next day, return to normal activities as far as you are comfortable.
• Do not drive. One hospital advises waiting 24 hours.
• Remove the plaster the next day.

Over the next few days

• More pain and stiffness for a few days is common.
• Carry on with your usual medicines and do not stop painkillers suddenly. Ask if you are unsure.
• People with diabetes should check their blood sugar more often.
• Note when the pain eased and by how much. This matters for your doctor’s next decision.

Once the pain eases

Increase movement little by little. After radiofrequency, build up activities such as walking and housework gradually, and do not take up new exercises until your muscles have adapted. After a joint injection, do not overuse the joint for two weeks. Strengthening your muscles helps the benefit last.

When to call

• Fever, or redness or discharge at the site
• A joint that has become hot and much more painful
• Weakness or numbness that has not gone after several hours, or is getting worse
• A severe headache

If you cannot pass urine, lose control of your bladder or bowels, or have numbness around the genitals, go to the emergency department at once.

Before the test

• Shower, and do not use cream, lotion, perfume or sunscreen on your arms and legs.
• Wear loose clothes that let sleeves or trouser legs be rolled up.
• In cold weather keep your hands and feet warm. Cold changes the result.
• Eat as usual.

Tell the doctor if you

• Have a pacemaker, defibrillator or other implant
• Take a blood thinner. Do not stop it yourself; ask your doctor.

During the test

The doctor will ask you to relax a muscle or tighten it a little. Say so whenever you are uncomfortable. The visit usually takes up to an hour.

After the test

Go back to your normal day. The needle site may be a little sore or bruised.

General rules

• Carry on with your daily activities as far as you can.
• Do not sit or lie down for long periods. Staying in bed does not help.
• Start short walks early. Swimming, yoga and pilates may also help.
• A heat pack suits stiffness and muscle spasm, and an ice pack suits pain and swelling. Wrap them in a towel.

What about the pain?

Moving can hurt a little, and that is not usually harm. If an exercise makes pain worse, stop it. Ask a doctor or pharmacist about painkillers, because not every medicine suits everyone.

Home exercises

Do the exercises your doctor or physiotherapist gave you regularly. They work through repetition, and one big day does not replace several.

When should we see you?

Book an appointment if you have not improved after a few weeks, if the pain is getting worse, or if it has taken over your daily life.

Go to the emergency department or call 115 at once

Back pain or sciatica with any of these:

• Numbness around the genitals or anus
• Being unable to pass urine, trouble starting, or losing control of your bladder
• Losing control of your bowels, or not noticing the need to go
• Pain, weakness or numbness in both legs, or weakness and numbness that is severe and getting worse
• Sciatica on both sides
• Changed feeling in the genitals during sex, or new trouble with erections
• Chest pain
• Pain that started after an accident or serious blow

These can be signs of a serious back problem. Do not drive yourself, and take your medicines with you.

Call a doctor the same day

• Fever, chills or feeling generally unwell along with back pain
• Severe pain that starts suddenly or gets worse quickly

Book an appointment soon

• Weight loss you cannot explain
• A lump, swelling or change in the shape of your back
• Pain that is worse at night and not eased by rest
• Pain that gets worse when you sneeze, cough or have a bowel movement
• Pain between the shoulder blades
• Pain that has not improved after a few weeks or disrupts your life

After an injection

If you have just had an injection, also read the guide to after an injection.